Question: There are certain functions (e.g., benefit integrity and coordination of benefit) that are not contained in the A/B MAC SOW. Will this work be done by the MACs?
Ultrasound Repair
Ceiling Fan
Angioplasty
Answer: Since comprehensive care is provided to PACE participants, those participants who need end-of-life care will receive the appropriate medical, pharmaceutical, and psychosocial services through the PACE organization. If the participant specifically wants to elect the hospice benefit from a certified hospice organization, then the participant must voluntarily disenroll from the PACE organization. The PACE organization would work with the State administering agency and CMS to facilitate the election of the hospice benefit
Monday, December 7, 2009
What is a Medicare Administrative Contractor?
Question: What is a Medicare Administrative Contractor?
Content Solutions
Masters Golf Tickets
Vending Machine
Answer : A Medicare Administrative Contractor (MAC) is the new contracting entity that is responsible for the receipt, processing and payment of Medicare fee-for-service claims. In addition to providing core claims processing operations for both Part A and Part B, the MAC will be the primary contact for physicians and perform functions related to: Appeals, Provider Outreach and Education, Financial Management, Provider Enrollment, Reimbursement, Payment Safeguards, and Information Systems Security.
Content Solutions
Masters Golf Tickets
Vending Machine
Answer : A Medicare Administrative Contractor (MAC) is the new contracting entity that is responsible for the receipt, processing and payment of Medicare fee-for-service claims. In addition to providing core claims processing operations for both Part A and Part B, the MAC will be the primary contact for physicians and perform functions related to: Appeals, Provider Outreach and Education, Financial Management, Provider Enrollment, Reimbursement, Payment Safeguards, and Information Systems Security.
Should I fill out the Initial Enrollment Questionnaire (IEQ) if I belong to an HMO?
Question: Should I fill out the Initial Enrollment Questionnaire (IEQ) if I belong to an HMO?
Wild Blue
Lechuza Planters
Carbide Tooling
Answer : Since comprehensive care is provided to PACE participants, those participants who need end-of-life care will receive the appropriate medical, pharmaceutical, and psychosocial services through the PACE organization. If the participant specifically wants to elect the hospice benefit from a certified hospice organization, then the participant must voluntarily disenroll from the PACE organization. The PACE organization would work with the State administering agency and CMS to facilitate the election of the hospice benefit.
Wild Blue
Lechuza Planters
Carbide Tooling
Answer : Since comprehensive care is provided to PACE participants, those participants who need end-of-life care will receive the appropriate medical, pharmaceutical, and psychosocial services through the PACE organization. If the participant specifically wants to elect the hospice benefit from a certified hospice organization, then the participant must voluntarily disenroll from the PACE organization. The PACE organization would work with the State administering agency and CMS to facilitate the election of the hospice benefit.
What is the UB-04?
Question: What is the UB-04?
Answer : The UB-04 is the basic form that CMS prescribes for the Medicare program. It is only accepted from institutional providers that are excluded from the mandatory electronic claims submission requirements set forth in the Administrative Simplification Compliance Act, Public Law 107-105 (ASCA), and the implementing regulation at 42 CFR 424.32. It incorporates the National Provider Identifier (NPI), taxonomy, and additional codes.
Aprilaire Humidifier
IP PBX
Restaurant Supply
Reference: http://www.cms.hhs.gov/mlnmattersarticles/downloads/MM5072.pdf
Answer : The UB-04 is the basic form that CMS prescribes for the Medicare program. It is only accepted from institutional providers that are excluded from the mandatory electronic claims submission requirements set forth in the Administrative Simplification Compliance Act, Public Law 107-105 (ASCA), and the implementing regulation at 42 CFR 424.32. It incorporates the National Provider Identifier (NPI), taxonomy, and additional codes.
Aprilaire Humidifier
IP PBX
Restaurant Supply
Reference: http://www.cms.hhs.gov/mlnmattersarticles/downloads/MM5072.pdf
Can participants receive hospice care while enrolled in PACE?
Question: Can participants receive hospice care while enrolled in PACE?
Answer: Since comprehensive care is provided to PACE participants, those participants who need end-of-life care will receive the appropriate medical, pharmaceutical, and psychosocial services through the PACE organization. If the participant specifically wants to elect the hospice benefit from a certified hospice organization, then the participant must voluntarily disenroll from the PACE organization. The PACE organization would work with the State administering agency and CMS to facilitate the election of the hospice benefit.
Home Security Systems
Pool Supplies
Refrigerator Water Filters
Answer: Since comprehensive care is provided to PACE participants, those participants who need end-of-life care will receive the appropriate medical, pharmaceutical, and psychosocial services through the PACE organization. If the participant specifically wants to elect the hospice benefit from a certified hospice organization, then the participant must voluntarily disenroll from the PACE organization. The PACE organization would work with the State administering agency and CMS to facilitate the election of the hospice benefit.
Home Security Systems
Pool Supplies
Refrigerator Water Filters
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